Journal of Hand Surgery RSS feed. https://www.jhandsurg.org/issues?journalCode=yjhsu&publicationCode=yjhsu&rss=yes Elsevier Inc. en © 2026 Published by Elsevier Inc. All rights reserved. Journal of Hand Surgery 0363-5023 2026-06-08-07:00 © 2026 Published by Elsevier Inc. All rights reserved. permissionshelpdesk@elsevier.com https://www.jhandsurg.org/article/S0363-5023(26)00371-0/fulltext?rss=yes The purpose of this study was to assess outcomes after treatment of scaphoid nonunion with open reduction internal fixation and nonvascularized autograft (NVA). Outcomes After Treatment of Scaphoid Nonunion With Open Reduction Internal Fixation and Nonvascularized Autograft Lynn Ann Forrester, Rafa Rahman, Raylin Xu, Michelle Carlson, Daniel Osei, Samir K. Trehan 10.1016/j.jhsa.2026.05.006 Journal of Hand Surgery (2026) 2026-06-08 Journal of Hand Surgery 2026-06-08 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00368-0/fulltext?rss=yes The degree to which motor and psychosocial functions may recover following hand and upper-extremity transplantation (HUET) remains unclear. This study quantifies HUET outcome changes in the first 10 years post-transplantation to provide insight into this question. Timeline of Functional Recovery Following Hand and Upper-Extremity Transplantation Isaac Mordukhovich, Connor Roncagli, Natalie Hoffner, Kyle Barclay, Antonio Rampazzo, Bahar Bassiri Gharb 10.1016/j.jhsa.2026.05.003 Journal of Hand Surgery (2026) 2026-06-05 Journal of Hand Surgery 2026-06-05 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00367-9/fulltext?rss=yes To evaluate whether a 30° passive metacarpophalangeal (MCP) joint hyperextension threshold was associated with postoperative mechanical and patient-reported outcomes when leaving MCP joint hyperextension unaddressed after performing trapeziectomy with suspensionplasty. Thumb Metacarpophalangeal Hyperextension in Patients Undergoing Basilar Thumb Joint Suspensionplasty: Are Preoperative Passive Measurements Predictive of Failure? Brandon Smetana, Drew Wrightson, Ryan Harold, Peter Henning, Gregory Merrell 10.1016/j.jhsa.2026.05.002 Journal of Hand Surgery (2026) 2026-06-05 Journal of Hand Surgery 2026-06-05 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00320-5/fulltext?rss=yes Wide-awake local anesthesia no tourniquet (WALANT) hand surgery produces less waste and carbon emissions than traditional operating room surgery. High procedural volumes and expanding adoption among hand surgeons’ position WALANT as a continued optimal target for waste-reduction initiatives. This study quantifies waste reduction after recycling implementation in a WALANT procedure room and identifies materials most contributory to total waste production. Recycling Implementation in Wide-Awake Local Anesthesia No Tourniquet Hand Surgery Miles C. Farlow, Bayli Price, Victoria Robinson, William G. Burks, Peter J. Apel, Cesar J. Bravo 10.1016/j.jhsa.2026.04.015 Journal of Hand Surgery (2026) 2026-06-01 Journal of Hand Surgery 2026-06-01 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00362-X/fulltext?rss=yes Extrinsic ligament injury is necessary for scapholunate (SL) diastasis to occur in SL ligament injury. Prior studies demonstrate an association between dorsal extrinsic ligament injury and SL diastasis, but it is unclear what is the importance of volar extrinsic injury. This study aimed to characterize injury to the dorsal intercarpal ligament (DIC), dorsal radicarpal ligament (DRC), volar extrinsic ligaments (LRL/SRL/RSC), and scaphotrapezotrapezial (STT) ligaments to determine what extrinsic ligament injuries are independently associated with SL diastasis. Association of Extrinsic Ligament Injury with Diastasis in Scapholunate Ligament Injury Lente H.M. Dankelman, Kevin Kooi, Rene Balza Romeo, Jad S. Husseini, Ambrose J. Huang, Oscar Y. Shen, Neal C. Chen 10.1016/j.jhsa.2026.04.020 Journal of Hand Surgery (2026) 2026-05-27 Journal of Hand Surgery 2026-05-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00324-2/fulltext?rss=yes Carpal tunnel syndrome (CTS) causes enlargement of the median nerve cross-sectional area (CSA), which often decreases after carpal tunnel release. However, the clinical relevance of postoperative median nerve CSA changes remains unclear. This study aimed to assess the association between postoperative changes in median nerve CSA and clinical outcomes and to identify factors linked to a persistent or increased CSA. Postoperative Reduction and Persistent Enlargement of Median Nerve Cross-Sectional Area in Carpal Tunnel Syndrome: Influence of Metabolic Syndrome Yotaro Yamada, Tadahiro Natsume, Michiro Yamamoto 10.1016/j.jhsa.2026.04.019 Journal of Hand Surgery (2026) 2026-05-27 Journal of Hand Surgery 2026-05-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00318-7/fulltext?rss=yes Ulnar nerve injury causes weak pinch strength through paralysis of the first dorsal interosseus and adductor pollicis muscles. Current reconstructive strategies provide variable reanimation of these muscles. It has been suggested that nerve transfer of the opponens pollicis (OPB) motor branch to the terminal division of the deep branch of the ulnar nerve (TDDBUN) may successfully restore pinch strength. The true effectiveness of this intervention remains unknown as there are few cases in the literature with all originating from a single author. Restoration of Pinch Strength After Traumatic Ulnar Nerve Injury: Outcomes of Transfer of the Opponens Pollicis Branch to the Terminal Division of the Deep Branch of the Ulnar Nerve Madeline Rieker, Richard Arendale, Julia Mastracci, Ryan Serbin, Kayla Hietpas, Bryan Loeffler, Glenn Gaston 10.1016/j.jhsa.2026.04.013 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00314-X/fulltext?rss=yes Polyetheretherketone anchors used for thumb metacarpophalangeal (MP) joint ulnar collateral ligament (UCL) repair/reconstruction may be associated with osteolysis and subsequent failure, which presents challenges to revision reconstruction. This study evaluated the biomechanical integrity of thumb UCL reconstruction in a cadaveric osteolysis model. Biomechanical Strength of Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Reconstruction With Button Autograft and Suture Suspension (BASS) Technique in a Cadaveric Osteolysis Model Riley Kahan, Dylan R. Rakowski, Evan H. Richman, Adam Peszek, Todd Baldini, Matthew Belton, Alexander Lauder 10.1016/j.jhsa.2026.04.009 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00218-2/fulltext?rss=yes To compare the mid- to long-term outcomes of radial shortening osteotomy (RSO) and proximal row carpectomy (PRC) in treating Kienböck’s disease, using patient-reported outcomes, functional measures, and rates of secondary surgery. Save or Salvage: Radial Shortening Osteotomy and Proximal Row Carpectomy in Kienböck’s Disease—A Descriptive Study Tanis Quaife, Ian Diffey, Lukas Hashem, Wrist and Elbow Research Canada (WECAN) Affiliates, Ruby Grewal 10.1016/j.jhsa.2026.02.031 Journal of Hand Surgery (2026) 2026-05-26 Journal of Hand Surgery 2026-05-26 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00319-9/fulltext?rss=yes Various surgical options exist to treat thumb carpometacarpal (CMC) osteoarthritis, including trapeziectomy-based procedures and CMC denervation. Presently, there is limited data on the relative longevity of these 2 procedures, with conflicting data on the rates of secondary conversion after CMC denervation. We sought to investigate the rates of secondary surgery in patients undergoing trapeziectomy or denervation for CMC osteoarthritis. Thumb Carpometacarpal Joint Denervation Has Lower Reoperation Rates Than Trapeziectomy for Thumb Base Arthritis: A Retrospective Database Study Julian Wier, Daniel Rusu, Aidan Lindgren, Ali Azad, Luke T. Nicholson 10.1016/j.jhsa.2026.04.014 Journal of Hand Surgery (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00309-6/fulltext?rss=yes To determine the influence of evaluator experience, dynamic versus static ultrasound (US) image interpretation, and probe frequency on fascicle differentiation. The Influence of Evaluator Experience, Dynamic Versus Static Ultrasound Image Interpretation, and Probe Frequency on Fascicle Differentiation Luka Pušnik, Natalie Winter, Maks Matej Cuzak, Igor Serša, Nejc Umek, Žiga Snoj, Gregor Omejec 10.1016/j.jhsa.2026.04.004 Journal of Hand Surgery (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00308-4/fulltext?rss=yes To compare the short-term clinical outcomes and fracture rate of the silicone implants AVANTA and INTEGRA for metacarpophalangeal (MCP) joint arthroplasty in patients with rheumatoid arthritis (RA). A Comparative Study of Short-Term Outcomes Between INTEGRA and AVANTA Silicone Implants for Metacarpophalangeal Joints in Patients With Rheumatoid Arthritis Shuichi Naniwa, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Masahiro Horita, Toshifumi Ozaki 10.1016/j.jhsa.2026.04.003 Journal of Hand Surgery (2026) 2026-05-25 Journal of Hand Surgery 2026-05-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00317-5/fulltext?rss=yes To evaluate the clinical and radiological outcomes of a hybrid fixation technique combining intramedullary screw fixation with minimally invasive suture cerclage for the treatment of long-oblique and spiral metacarpal shaft fractures, patterns traditionally considered suboptimal for isolated intramedullary screw fixation. Minimally Invasive Hybrid Fixation for Unstable Metacarpal Shaft Fractures: A New Approach to Extend Intramedullary Screw Indications Sergi Barrera-Ochoa, Rita Pereira Cavaca, Andrés Alvial-San Martín, Pilar Saralegui, Beatriz Miron-Dominguez, Melissa Bonilla-Chaperon 10.1016/j.jhsa.2026.04.012 Journal of Hand Surgery (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00316-3/fulltext?rss=yes In many nerve injuries, tissue destruction, scar, and other factors prohibit surgical reapproximation of the nerve ends without excessive tension. The resultant nerve gap has traditionally been bridged using autologous sensory nerve; however, the harvest of autologous nerve graft adds time and donor site morbidity. Over the past decades, a variety of commercially available hollow conduits designed for nerve gap reconstruction have been used. More recently, commercially available processed human nerve allograft has been introduced with the promise of reconstruction whose success rivals the results of nerve autograft. Nerve Gap Reconstruction Casey Imbergamo, Ellie Moeller, Sierra Lindsey, Aviram M. Giladi, Joel S. Solomon 10.1016/j.jhsa.2026.04.011 Journal of Hand Surgery (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00310-2/fulltext?rss=yes Unlike pediatric trigger thumb, which is cured by A1 pulley release, pediatric trigger fingers (PTFs) have a high rate of recurrence with A1 pulley release alone. The flexor digitorum superficialis (FDS) splitting technique has the potential to mitigate recurrence without the need for more extensive dissection. This study investigates the clinical outcomes of A1 pulley release with concomitant A2 pulley partial release and FDS splitting in the treatment of PTF. Resolution of Pediatric Trigger Finger After Combined A1 Pulley Release, A2 Pulley Partial Release, and Flexor Digitorum Superficialis Tendon Split Timothy W. Kouo, Dan Gordon, Aaron Perkins, David Farbo, Pamela J. Sherman 10.1016/j.jhsa.2026.04.005 Journal of Hand Surgery (2026) 2026-05-23 Journal of Hand Surgery 2026-05-23 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00315-1/fulltext?rss=yes Pediatric hand surgery frequently requires precise surgical reconstruction of the upper limb to prevent worsening deformity. However, there is a balance of achieving a perfect radiologic film of the planned surgery and causing inadvertent harm from performing overly aggressive surgery. Precise K-wire placement and immobilization are important for optimal results; however, surgery that is too invasive results in several downsides, including loss of reduction, poor bony healing, loss of blood supply, growth plate failure, and scar contractures from poor wound healing. Good Enough: When to Avoid Perfection and Accept Adequate Surgery Results in Pediatric Hand Surgery Alex J. Davit, Kelsi N. Krakauer, Aaron J. Berger, Michael G. Galvez 10.1016/j.jhsa.2026.04.010 Journal of Hand Surgery (2026) 2026-05-21 Journal of Hand Surgery 2026-05-21 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00251-0/fulltext?rss=yes The purpose of this study was to compare wrist range of motion (ROM) and tendon forces before and after implantation of a recently designed total wrist arthroplasty (TWA). Our hypothesis was that following TWA, the ROM would decrease and the tendon forces increase. In Vitro Kinetic and Kinematic Analysis of a Recently Designed Total Wrist Implant Salvatore M. Cavallaro, Brian J. Harley, Frederick W. Werner 10.1016/j.jhsa.2026.03.015 Journal of Hand Surgery (2026) 2026-05-18 Journal of Hand Surgery 2026-05-18 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00250-9/fulltext?rss=yes Considerable variation exists in strategies for the diagnosis and treatment of neurogenic thoracic outlet syndrome (NTOS). Additionally, different subtypes of NTOS present with different constellations of symptoms and signs. The aim of this study was to gather and evaluate different treatment plans from high-volume NTOS surgeons for standardized case scenarios. Strategies for Work-up and Treatment of Case Scenarios in Neurogenic Thoracic Outlet Syndrome Harvey Chim, INTOS Workgroup 10.1016/j.jhsa.2026.03.014 Journal of Hand Surgery (2026) 2026-05-18 Journal of Hand Surgery 2026-05-18 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00252-2/fulltext?rss=yes Thumb carpometacarpal (CMC) joint arthritis often presents with metacarpophalangeal (MCP) joint hyperextension. Although CMC joint arthrodesis and trapeziectomy are established treatments, their effects on MCP joint hyperextension and functional outcomes stratified by MCP joint status remain unclear. We assessed correction of MCP joint hyperextension and functional improvement according to preoperative MCP joint status after CMC joint arthrodesis or trapeziectomy and compared outcomes between procedures in patients with preoperative MCP joint hyperextension. Arthrodesis Versus Trapeziectomy for Thumb Carpometacarpal Joint Arthritis with Metacarpophalangeal Joint Hyperextension Tomoki Matsuo, Masao Nishiwaki, Masato Okazaki, Yasuhiro Kiyota, Taku Suzuki, Takuji Iwamoto, Kenichi Tazaki 10.1016/j.jhsa.2026.03.016 Journal of Hand Surgery (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00245-5/fulltext?rss=yes Hand surgeons face unique ergonomic challenges because of prolonged seated positions, precise motor demands, postural strain from magnification equipment, and repetitive micromovements. Ergonomic interventions specific to hand surgery remain grossly understudied. This nonsystematic review addresses the musculoskeletal burden in hand surgery and provides evidence-based ergonomic recommendations. For microsurgery, maintaining neutral head positioning with properly aligned microscopes and incorporating microbreaks reduced strain. Sustainable Surgery: A Hand Surgeon’s Guide to Ergonomics Tobi J. Somorin, Sripadh B. Sharma, April Chambers, Mark S. Redfern, Nicole J. Jarrett 10.1016/j.jhsa.2026.03.009 Journal of Hand Surgery (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 Current Concepts https://www.jhandsurg.org/article/S0363-5023(25)00715-4/fulltext?rss=yes We investigated the complication profile and effectiveness of arthrodesis, trapeziectomy without suspensionplasty or ligament reconstruction (S/LR), trapeziectomy with S/LR, and joint replacement (JR) for the management of base-of-thumb arthritis. We included cases of interposition material placement within the trapeziectomy without the S/LR group. Clinical Outcomes of Surgical Options for Base-of-Thumb Arthritis: A Systematic Review and Network Meta-Analysis Nikki Burnett, Tim Cheok, Kenneth Wills, Zachary Van Hout, Yun Xiang Zhang, Max McCarthy, Thomas Smith, Ruurd Jaarsma, Narlaka Jayasekera 10.1016/j.jhsa.2025.12.011 Journal of Hand Surgery (2026) 2026-05-15 Journal of Hand Surgery 2026-05-15 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00512-X/fulltext?rss=yes Although carpal tunnel release (CTR) is a common procedure for carpal tunnel syndrome (CTS), few studies define the postoperative recovery timeline for CTR. Therefore, we aimed to investigate the timing to achieve a clinically meaningful improvement and the timing for reaching a plateau in improvement in patient-reported outcome measurements (PROMs) after CTR for CTS. Second, we compared the improvement trend in PROMs with that of nerve conduction studies. Longitudinal Changes in Patient-Reported Outcomes Following Carpal Tunnel Release: A Retrospective Cohort Study Kosuke Saito, Mitsuhiro Okada, Shunpei Hama, Yusuke Miyashima, Hidetomi Terai 10.1016/j.jhsa.2025.09.011 Journal of Hand Surgery (2026) 2026-05-08 Journal of Hand Surgery 2026-05-08 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00249-2/fulltext?rss=yes The majority of brachial plexus birth injuries (BPBI) occur without prenatally identifiable risk factors. This meta-analysis mapped BPBI incidence worldwide as a preliminary step toward investigating population-level predictors. Mapping Population-Level Differences in Brachial Plexus Birth Injury: An International Meta-Analysis Holly Cordray, Miguel Fiandeiro, Seungjun Lee, Roger Cornwall, Petra Grahn, Marja Kaijomaa, M. Claire Manske, Melissa Previtera, Apurva S. Shah 10.1016/j.jhsa.2026.03.013 Journal of Hand Surgery (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00248-0/fulltext?rss=yes Timely and high-quality hand and upper-extremity care should be accessible to all patients. Certain demographic factors like age and body mass index have been consistently linked to differences in care, yet the influence of the social determinants of health (SDOH) remains a growing area of research. This study uses the three-delays model to evaluate associations between health inequities, as measured by the PROGnosis RESearch Strategy (PROGRESS) framework, and access to timely and high-quality hand and upper-extremity care. Evaluating Associations Between Health Equity and High-Quality Care in Hand and Upper-Extremity Care: A Systematic Review Angel X. Xiao, Katherine R. Miclau, Mandeep Kaur, Scott Liu, Lauren M. Shapiro 10.1016/j.jhsa.2026.03.012 Journal of Hand Surgery (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00246-7/fulltext?rss=yes The wide-awake local anesthesia no tourniquet (WALANT) approach has been proposed as a promising alternative to general anesthesia (GA) for hand surgery. However, evidence in the pediatric population remains limited. The objective of this study was to evaluate its impact on clinical outcomes, procedural efficiency, and institutional costs for pediatric trigger thumb (PTT) release. Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus General Anesthesia for Pediatric Trigger Thumb Release: Clinical Outcomes, Efficiency, and Costs Aidan Shulkin, Xiya Ma, Daniel Borsuk, Charlotte Jaloux, Emilie Bougie 10.1016/j.jhsa.2026.03.010 Journal of Hand Surgery (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00130-9/fulltext?rss=yes This study investigated the influence of preoperative intra-articular steroid injections on surgical outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty and arthrodesis and aimed to determine whether preoperative steroid injections affect the choice of surgical procedures for treating painful thumb carpometacarpal osteoarthritis. Do Preoperative Intra-Articular Steroid Injections Affect the Choice of Surgical Procedures for Thumb Carpometacarpal Osteoarthritis? Shingo Komura, Akihiro Hirakawa, Hitoshi Hirose, Atsushi Kawaguchi, Yoshiki Ito, Haruhiko Akiyama 10.1016/j.jhsa.2026.01.024 Journal of Hand Surgery 51, 6 (2026) 2026-05-07 Journal of Hand Surgery 2026-05-07 51 6 S0363-5023(26)X2004-4 Arthroplasty/Arthrodesis: Curated by Gustavo Gómez Rodríguez 631.e1 631.e10 https://www.jhandsurg.org/article/S0363-5023(26)00132-2/fulltext?rss=yes Concomitant limitation of shoulder abduction and external rotation is commonly seen in residual upper plexus brachial plexus birth injury. However, a subset of patients presents with preserved external rotation but diminished abduction, suggesting a disproportionate limitation. In these patients, application of an elbow extension splint improves abduction — a clinical observation termed the elbow block test (EBT). This study evaluates the clinical significance, etiological basis and pattern of brachial plexus involvement associated with EBT. Elbow Block Test: A Clinical Sign of C7 Nerve Injury in Residual Brachial Plexus Birth Injury Maulin M. Shah, Nischal Naik, Tejas Patel, Shalin Shah, Joyance James Mammen, Saumya Shah, Preksha Vijay 10.1016/j.jhsa.2026.02.004 Journal of Hand Surgery 51, 6 (2026) 2026-05-04 Journal of Hand Surgery 2026-05-04 51 6 S0363-5023(26)X2004-4 Pediatric Hand and Upper Extremity: Curated by Michelle James 668 677 https://www.jhandsurg.org/article/S0363-5023(26)00247-9/fulltext?rss=yes The purpose of this study was to compare the failure rate of primary trigger finger corticosteroid injections (CSIs) using triamcinolone versus betamethasone. The Effect of Corticosteroid Type on Failure Following Primary Trigger Finger Injection Justin M. Kistler, Jeremiah A. Adams, Bryan A. Hozack, Jonas L. Matzon 10.1016/j.jhsa.2026.03.011 Journal of Hand Surgery (2026) 2026-05-02 Journal of Hand Surgery 2026-05-02 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00225-X/fulltext?rss=yes The goal of this anatomical clinical study is to clarify whether a simple pisiformectomy can provide sufficient decompression of the ulnar nerve along its entire course within the ulnar canal. Management of Ulnar Nerve Irritation by Pisiformectomy: A Clinical Anatomical Study Jaroslav Pilný, Petr Hájek, Tomáš Janoušek, David Kachlík 10.1016/j.jhsa.2026.03.002 Journal of Hand Surgery (2026) 2026-04-28 Journal of Hand Surgery 2026-04-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00243-1/fulltext?rss=yes Peripheral nerve injuries have profound consequences for physical, psychological, and social functioning. Advances have improved outcomes; however, patients frequently experience residual symptoms and incomplete recovery. Traditional measures of success emphasize clinician-defined benchmarks, which may not fully capture the lived experience of recovery. This study explores how patients define “success” after nerve reconstruction, how these definitions align or diverge from those used by clinicians, and the contextual factors that shape patient perceptions of recovery. Measuring What Matters: Patient Perspectives on Success and Recovery After Nerve Injury Bryce F. Rizvanović, Julia A.V. Nuelle, Daniel A. London, Lisa A. Royse 10.1016/j.jhsa.2026.03.007 Journal of Hand Surgery (2026) 2026-04-27 Journal of Hand Surgery 2026-04-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00221-2/fulltext?rss=yes To evaluate, using finite element analysis, how progressive loss of radial inclination (RI) influences ulnar abutment mechanics when volar tilt (VT) is maintained as normal in association with increasing ulnar variance. Decreased Radial Inclination Without Dorsal Angulation Attenuates the Biomechanical Effects of Ulnar Abutment Syndrome: A Finite Element Analysis Takane Suzuki, Yusuke Matsuura, Takahiro Yamazaki, Atsushi Hojo, Seiji Ohtori 10.1016/j.jhsa.2026.02.034 Journal of Hand Surgery (2026) 2026-04-27 Journal of Hand Surgery 2026-04-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00242-X/fulltext?rss=yes The motor branch to the brachialis muscle has been described as a versatile donor in upper limb nerve reconstruction. This includes patients with peripheral nerve injuries and tetraplegia. However the anatomic feasibility of transfers from the musculocutaneous nerve to radial nerve branches around the elbow has not been systematically evaluated. This study aims to assess this feasibility. Such a transfer may be particularly relevant in patients with high-level tetraplegia or in patients with spastic upper limb involvement, in which selective denervation of spastic elbow flexors could be combined with nerve transfer to paretic wrist and/or finger extensors. Brachialis Branch to Radial Nerve Transfer for Reanimation of Wrist and Finger Extension: An Anatomical Feasibility Study De Lepeleere Bram, Plasschaert Frank, Cornette Bram, Cordier Fleur, Fitoussi Franck 10.1016/j.jhsa.2026.03.006 Journal of Hand Surgery (2026) 2026-04-25 Journal of Hand Surgery 2026-04-25 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00212-1/fulltext?rss=yes The main postoperative complications after fixation of ulna shaft fractures are nonunion and soft tissue irritation. Current standards recommend 3.5 mm locking compression plates, which are prone to cause soft tissue irritation, necessitating secondary implant removal in approximately 25% of cases. Therefore, an alternative approach considering a combination of two minifragment locking plates has been proposed. The aim of this study was to biomechanically compare a single 3.5 mm locking compression plate fixation versus dual minifragment locked plating of ulna shaft fractures in a human cadaveric model. Biomechanical Analysis of Standard Locking Compression Plate versus Dual Minifragment Locking Plates in Ulna Shaft Fracture Fixation: A Human Cadaveric Study Moritz Kraus, Luke van Rossenberg, Ivan Zderic, Tatjana Pastor, Boyko Gueorguiev, R. Geoff Richards, Tabea Katharina Breckwoldt, Hans-Christoph Pape, Frank J.P. Beeres, Torsten Pastor 10.1016/j.jhsa.2026.02.025 Journal of Hand Surgery (2026) 2026-04-24 Journal of Hand Surgery 2026-04-24 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00171-1/fulltext?rss=yes To investigate the value of shear wave elastography (SWE) and blood flow parameters based on conventional ultrasound in evaluating healing status and functional recovery after surgical repair of hand flexor tendon lacerations. Evaluation Value of Shear Wave Elastography and Blood Flow Parameters in Functional Recovery After Surgical Repair of Hand Flexor Tendon Laceration Zelin Xu, Tingting Du, Guanming Zeng, Wenhan Zhang, Ming Chen, Xinhui Du, Hongtao Yu, Yangxin Zeng, Huanhuan Jin, Zhuoxun Li, Jun Li 10.1016/j.jhsa.2026.02.022 Journal of Hand Surgery 51, 6 (2026) 2026-04-24 Journal of Hand Surgery 2026-04-24 51 6 S0363-5023(26)X2004-4 Tendon: Curated by Armin Kraus 686.e1 686.e10 https://www.jhandsurg.org/article/S0363-5023(26)00241-8/fulltext?rss=yes The purpose of this study was to compare the clinical and radiographic outcomes 5 years after randomization to volar plating or combined plating for surgical treatment of an AO (Arbeitsgemeinschaft für Osteosynthesefragen) type C distal radius fracture (DRF). Volar Plating Versus Combined Plating For AO Type C Distal Radius Fracture: A Randomized Controlled Study Of 135 Patients With A 5-Year Follow-Up Ásgerdur Thórdardóttir, Marcus Sagerfors, Jonny Andersson, Hana Gavlovská, Eva Lundqvist 10.1016/j.jhsa.2026.03.005 Journal of Hand Surgery (2026) 2026-04-21 Journal of Hand Surgery 2026-04-21 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00244-3/fulltext?rss=yes Thumb phalangeal and metacarpal fractures are undergoing surgical intervention more frequently and can be stabilized using a range of modalities. Intramedullary screw (IMS) fixation has become more common in the management of these fractures. Violation of the articular cartilage and the extensor tendon is a concern when IMS fixation is used. The aim of this study was to assess the cartilaginous and soft tissue footprint resulting from retrograde IMS insertion in the proximal phalanx and metacarpal of the thumb. Soft Tissue Violation Following Intramedullary Screw Fixation of Fractures in the Thumb: A Cadaveric Study Samuel Gray, Michael Strong, Elizabeth Clarke, David Graham, Brahman Sivakumar 10.1016/j.jhsa.2026.03.008 Journal of Hand Surgery (2026) 2026-04-20 Journal of Hand Surgery 2026-04-20 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00227-3/fulltext?rss=yes Carpal tunnel syndrome is the most common upper-extremity compressive neuropathy, resulting from increased pressure within the carpal tunnel leading to symptomatic median nerve dysfunction. While conservative measures may offer temporary relief, surgical decompression remains the definitive treatment for persistent or progressive disease. Multiple surgical techniques for carpal tunnel release (CTR) have been described, each with distinct advantages and limitations. This review provides an updated synthesis of the evidence surrounding CTR, beginning with an overview of the conventional open and the mini-open approaches. Carpal Tunnel Release Surgical Techniques Rayan El Bachaoui, Brandon E. Earp, Philip E. Blazar, Dafang Zhang 10.1016/j.jhsa.2026.03.004 Journal of Hand Surgery (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00213-3/fulltext?rss=yes The application of arthroscopy in the proximal interphalangeal joints can avoid scar development and joint contracture. However, conventional arthroscopic techniques are difficult to apply to the palmar side of the joint. This study aimed to explore the feasibility and safety of the inside-out volar portal arthroscopic technique for the proximal interphalangeal joint, elucidating a new portal technique for the inspection and treatment of small joints. Inside-out Volar Portal of Arthroscopy of Proximal Interphalangeal Joints: A Cadaver Study Yuwei Liu, You Xie, Yangyang Hong, Jianquan Liu, Wencui Li, Zhe Zhao 10.1016/j.jhsa.2026.02.026 Journal of Hand Surgery (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00172-3/fulltext?rss=yes Upper-extremity spasticity is a functionally limiting symptom of upper motor neuron syndrome that can lead to musculotendinous and joint contractures. Surgical interventions, including hyperselective and selective neurectomies, have shown sustained efficacy in treating the spastic upper limb and have recently gained notable traction. We hypothesized that, in the long-term, surgical procedures are a cost-effective option for management of upper-extremity spasticity compared with neurotoxin therapy. Comparative Cost Analysis of Surgery Versus Neurotoxin Injection for Long-Term Management of Upper-Extremity Spasticity Benjamin Savitz, Orlane Caro, Mariam Saad, Daniel O’Neill, Shady Elmaraghi 10.1016/j.jhsa.2026.02.023 Journal of Hand Surgery (2026) 2026-04-16 Journal of Hand Surgery 2026-04-16 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00224-8/fulltext?rss=yes This study aimed to evaluate the prognostic importance of radial translation on functional outcomes in patients treated nonoperatively or surgically for distal radial fractures. It was hypothesized that increased radial translation would be associated with worse functional scores, regardless of treatment modality. Evaluation of the Relationship Between Radial Translation and Functional Outcomes in Nonsurgical and Surgically Treated Distal Radius Fractures Yusuf Yahşi, Yusuf Sülek, Süleyman Çakırtürk, Rodi Ertoğrul, Hacı Mustafa Özdemir 10.1016/j.jhsa.2026.02.037 Journal of Hand Surgery (2026) 2026-04-15 Journal of Hand Surgery 2026-04-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00223-6/fulltext?rss=yes The aim of this study was to evaluate the interobserver reliability of 3 commonly used arthroscopic diagnostic signs for assessing triangular fibrocartilage complex (TFCC) lesions: the trampoline test, the hook test, and the suction test. Interobserver Reliability of the Trampoline Test, Hook Test, and Suction Test in Arthroscopic Assessment of Triangular Fibrocartilage Complex Lesions Hideo Hasegawa, Michel Levadoux, Alexandre Quemener-Tanguy, Lucas Audiffret, Jean-Baptiste De Villeneuve Bargemon 10.1016/j.jhsa.2026.02.036 Journal of Hand Surgery (2026) 2026-04-15 Journal of Hand Surgery 2026-04-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00147-4/fulltext?rss=yes Polyethylene glycol (PEG) fusion has been reported to restore axonal continuity after nerve repair if initiated before Wallerian degeneration (WD). Sterile α and Toll/Interleukin-1 Receptor motif-containing 1 (SARM1) inhibition can potentially delay WD. We hypothesized that PEG fusion in SARM1 knockout (KO) rats would allow for improved strength and nerve regeneration following nerve transection. Functional and Histological Outcomes After Polyethylene Glycol Fusion of Rat Sciatic Nerve Transection Tony Y. Lee, Daniel A. Hunter, Ronaldo Perez, Christopher J. Dy, David M. Brogan 10.1016/j.jhsa.2026.01.031 Journal of Hand Surgery (2026) 2026-04-15 Journal of Hand Surgery 2026-04-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00151-6/fulltext?rss=yes The expression of the sonic hedgehog protein has been associated with induction of both radial longitudinal deficiency (RLD) and radial polydactyly in animal studies. We sought to investigate the co-occurrence of thumb hypoplasia/RLD and radial polydactyly in a large registry patient cohort and to investigate the clinical presentations of such patients. Association Between Thumb Hypoplasia, Radial Longitudinal Deficiency, and Radial Polydactyly Emma Payne, Charles A. Goldfarb, M. Claire Manske, Apurva Shah, Andrea Bauer, Lindley B. Wall, CoULD Study Group 10.1016/j.jhsa.2026.02.014 Journal of Hand Surgery (2026) 2026-04-14 Journal of Hand Surgery 2026-04-14 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00226-1/fulltext?rss=yes Recommendations for perioperative management of biologic disease-modifying antirheumatic drugs (bDMARDs) in hand surgery were historically adopted from other surgical specialties. The purpose of our study was to estimate the risks of surgical site infections (SSIs) and wound healing failures in patients with rheumatoid arthritis (RA) treated with bDMARDs undergoing elective hand surgery. Perioperative Biologic Disease-Modifying Antirheumatic Drugs, Risks of Infections, and Wound Complications in Patients With Rheumatoid Arthritis Undergoing Elective Hand Surgery Jackson M. Cathey, Paige J. Carrigan, Justin Zhang, Kevin M. Klifto 10.1016/j.jhsa.2026.03.003 Journal of Hand Surgery (2026) 2026-04-13 Journal of Hand Surgery 2026-04-13 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00222-4/fulltext?rss=yes To characterize volar shear fractures of the distal radius using computed tomography (CT) imaging to better evaluate dorsal cortical fracture involvement, articular complexity, and morphologic features to assist in operative planning. Distal Radius Volar Shear Fractures: A Computed Tomography Characterization and Analysis Eric J. Gullborg, Farhan Ahmad, Caitlin M. Ward, Alexander L. Hornung, Robert W. Wysocki, Xavier C. Simcock 10.1016/j.jhsa.2026.02.035 Journal of Hand Surgery (2026) 2026-04-13 Journal of Hand Surgery 2026-04-13 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00216-9/fulltext?rss=yes Fingertip amputations present a reconstructive challenge because of the varying degrees of tissue loss, bony exposure, and functional impact. Often, providers must decide between occlusive dressings and local flap reconstruction. This systematic review aims to analyze outcomes of both treatment modalities to determine the benefits and risks of each. Choosing Local Flaps Versus Occlusive Dressings in Fingertip Amputations: A Systematic Review and Meta-Analysis With Proposed Algorithm Kasra Rahmati, Nirbhay S. Jain, Rashed Alananzeh, Lauren E. Wessel 10.1016/j.jhsa.2026.02.029 Journal of Hand Surgery (2026) 2026-04-08 Journal of Hand Surgery 2026-04-08 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00220-0/fulltext?rss=yes Lunate and perilunate dislocations are uncommon wrist injuries that have a high reported association with acute median neuropathy, frequently referred to as acute carpal tunnel syndrome (ACTS). Previous investigations into the incidence of lunate and perilunate dislocation and acute median neuropathy have often been limited by small sample sizes. The purpose of our study was to report a relatively large cohort examining the incidence of ACTS in lunate and perilunate dislocations and assess predictive risk factors. The Risk of Acute Carpal Tunnel Syndrome in Lunate and Perilunate Dislocations Christina Wassef, Jenna Chrabolowski, Fangshouh Cheng, Cynthis Wong, Cody Perry, Rajnandini Aswani, William F. Pientka 10.1016/j.jhsa.2026.02.033 Journal of Hand Surgery 51, 6 (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 51 6 S0363-5023(26)X2004-4 Nerve: Curated by Harvey W. Chim 667.e1 667.e7 https://www.jhandsurg.org/article/S0363-5023(26)00219-4/fulltext?rss=yes The dynamic evaluation of ulnar impaction syndrome has recently garnered interest; however, its underlying mechanism remains unclear. This research aimed to analyze the dynamic ulnar impaction biomechanically during axial loading. Influence of Dynamic Factors on Ulnar Impaction Syndrome: An Axial Compression Test Using Fresh-Frozen Cadavers Kinshiro Nabeshima, Yusuke Matsuura, Takahiro Yamazaki, Aya Kanazuka, Seiji Ohtori, Takane Suzuki 10.1016/j.jhsa.2026.02.032 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00217-0/fulltext?rss=yes There is a growing consensus that replanted fingertips can survive with arterial anastomosis alone. This study aimed to evaluate outcomes among individuals undergoing artery-only replantation compared with those undergoing both arterial and venous replantation and to identify factors associated with outcomes. Outcomes of Artery-Only Digital Replantation Koichi Kobayashi, Ken Nishimura, Naoko Masuyama, Runa Sugawara, Satoru Kamekura, Yoshimi Kodoi 10.1016/j.jhsa.2026.02.030 Journal of Hand Surgery 51, 6 (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 51 6 S0363-5023(26)X2004-4 Arthroplasty/Arthrodesis: Curated by Gustavo Gómez Rodríguez 633.e1 633.e7 https://www.jhandsurg.org/article/S0363-5023(26)00215-7/fulltext?rss=yes The surgical treatment of trigger fingers may, in some instances, involve partial or complete resection of the flexor digitorum superficialis (FDS) tendon. Examples include continued triggering noted intraoperatively following A1 pulley release, associated proximal interphalangeal joint contractures, and postoperative residual or recurrent mechanical symptoms. Ulnar FDS slip excision in the palm only has been described, yet the anatomic consequences of a single-incision approach are not well quantified. Ulnar Slip Flexor Digitorum Superficialis Excision in Trigger Finger Surgery: Anatomic Study Ryan C. Cassidy, Elizabeth Plocher, Jack Bragg, Charles Cassidy 10.1016/j.jhsa.2026.02.028 Journal of Hand Surgery 51, 6 (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 51 6 S0363-5023(26)X2004-4 Tendon: Curated by Armin Kraus 680 684 https://www.jhandsurg.org/article/S0363-5023(26)00167-X/fulltext?rss=yes Surgical treatment of thumb carpometacarpal arthritis is common, with more than 40,000 procedures performed annually in the United States. Ligament reconstruction and tendon interposition (LRTI) remains a widely used technique with extensive longitudinal data, whereas suture-button suspensionplasty (SBS) has emerged as an alternative that avoids tendon harvest. This study compared early recovery patterns, patient-reported outcomes, and complications following LRTI and SBS. Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis John Mwangi, Alyssa R. Henriquez, Chanel R. Varney, Ryon Yu, Joshua K. Kim, Rafeal L. Baker, Tyler Pidgeon, Warren C. Hammert 10.1016/j.jhsa.2026.02.019 Journal of Hand Surgery 51, 6 (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 51 6 S0363-5023(26)X2004-4 Arthroplasty/Arthrodesis: Curated by Gustavo Gómez Rodríguez 623 630 https://www.jhandsurg.org/article/S0363-5023(26)00164-4/fulltext?rss=yes Carpometacarpal fractures and dislocations are commonly unrecognized injuries. Treating physicians need to maintain a high index of suspicion regarding this particular injury as delay in diagnosis and treatment can lead to a suboptimal outcome. Mechanism of injury often entails high-energy trauma or an axial blow to a closed fist. Thorough physical examination and adequate imaging are necessary during initial evaluation. Closed management and immobilization can be considered if the injury is recognized early; however, surgical reduction and stabilization are more commonly warranted. Current Concepts: Lesser Digit Carpometacarpal Joint Fracture-Dislocations Remy V. Rabinovich, Elizabeth Tell, Daniel B. Polatsch, Steven Beldner 10.1016/j.jhsa.2026.02.016 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00140-1/fulltext?rss=yes Although hand transplantation in the adult population is increasingly recognized as an acceptable reconstructive treatment, the ethical trade-offs of performing hand transplants in the pediatric population require closer scrutiny. This analysis applies the concepts of the best interest standard, the Harm Principle, and protections for vulnerable populations to weigh the risks and benefits of immunocompetent pediatric hand transplantation. As only two pediatric hand transplants have been performed to date, much of the outcome data has been extrapolated from the adult population. Current Ethics of Hand Transplants in Non-Immunocompromised Children Jaclyn T. Mauch, Leah M. Gudex, Casey J. Humbyrd, Ines C. Lin, Christian J. Vercler 10.1016/j.jhsa.2026.02.008 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00139-5/fulltext?rss=yes Given their stiffness, ultra-high molecular weight polyethylene (UHMWPE) sutures exhibit poor knot-holding capacity and are prone to unraveling. Surgeons often add extra throws to enhance knot security, leading to bulky knots, which can be problematic in procedures like flexor tendon repair. This study evaluated how different tensile forces applied to the suture ends prior to cutting affect the knot security of UHMWPE sutures. Tensile Force Applied Prior to Cutting Affects Knot Security in Small-Caliber Ultra-High Molecular Weight Polyethylene Suture Charles Nolte, Todd Baldini, Cara Thorne, Andy Lalka, O. Alton Barron, Louis W. Catalano 10.1016/j.jhsa.2026.01.028 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00136-X/fulltext?rss=yes Osteoarthritis of the distal interphalangeal (DIP) joint is highly prevalent and often managed with arthrodesis, which sacrifices motion and carries a risk of complications. Joint denervation preserves motion but has traditionally failed to address the aesthetic concerns associated with Heberden nodes. This study aims to describe the DIP joint denervation associated with cheilectomy and to report its medium-term outcomes regarding pain, motion, aesthetics, and complications. Denervation with Cheilectomy of the Distal Interphalangeal Joint: Technique and Medium-Term Results Jefferson Braga Silva, Marlon Muniz, Pierre-Emmanuel Chammas, Michel Chammas, Jorge G. Boretto 10.1016/j.jhsa.2026.01.027 Journal of Hand Surgery 51, 6 (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 51 6 S0363-5023(26)X2004-4 Nerve: Curated by Harvey W. Chim 666.e1 666.e9 https://www.jhandsurg.org/article/S0363-5023(26)00053-5/fulltext?rss=yes Complex regional pain syndrome (CRPS) is an uncommon but debilitating complication following distal radius fractures (DRFs). This study aimed to evaluate a broad set of preexisting comorbidities, including substance-use disorders, psychiatric conditions, compressive neuropathies, upper-limb traumatic nerve injuries, and cervical radiculopathy and determine their associations with CRPS development after DRF. A Nationwide Propensity Score-Matched Analysis Identifying Preinjury Predictors of Complex Regional Pain Syndrome Following Distal Radius Fracture Nirav K. Mungalpara, William K. Reiser, Logan Van Poucke, Gautam Malhotra, Alfonso Mejia, Mark H. Gonzalez 10.1016/j.jhsa.2026.01.004 Journal of Hand Surgery (2026) 2026-04-03 Journal of Hand Surgery 2026-04-03 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00211-X/fulltext?rss=yes Sign language is a predominant form of nonverbal communication in the United States with 7 million signers nationally, one million of which are deaf or hard-of-hearing. This population is particularly vulnerable to impaired communication when confronting upper-extremity impairment resulting from extensive long-term use in their communication. Given the high importance of adequate upper-extremity mobility for sign language users, hand surgeons must carefully choose the appropriate treatment modalities to minimize disruptions in this population’s ability to communicate in their daily lives. Talk Through the Hand: Upper-Extremity Injury and Surgical Considerations in Sign Language Users Sarah A. Uriarte, Jason Nguyen, Ali Mansour, Elijah M. Persad, Vinay Rao, Reena A. Bhatt 10.1016/j.jhsa.2026.02.024 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00169-3/fulltext?rss=yes Current functional assessments after brachial plexus (BP) reconstruction, including surgeon-graded active range of motion and strength scores, and patient-reported outcomes (PROs), have limitations. This study evaluated the feasibility of wearable sensors to quantify recovery and functional outcomes following BP reconstruction. We hypothesized that sensor-derived measures of daily upper-extremity use would correlate with PROs and that real-world upper-extremity use would improve. Use of Wearable Sensors to Measure Improvements in Real World Upper Extremity Activity After Brachial Plexus Reconstruction Arakua N. Welbeck, Catherine E. Lang, David M. Brogan, Christopher J. Dy 10.1016/j.jhsa.2026.01.034 Journal of Hand Surgery 51, 6 (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 51 6 S0363-5023(26)X2004-4 Pediatric Hand and Upper Extremity: Curated by Michelle James 678.e1 678.e8 https://www.jhandsurg.org/article/S0363-5023(26)00168-1/fulltext?rss=yes To characterize delayed “hidden” nail regrowth after homodigital dorsal adipofascial reverse flap reconstruction of distal fingertips and to evaluate the outcomes of a standardized, matrix-sparing secondary exposure technique. Exposing the Hidden Nail: Matrix-Sparing Secondary Exposure After Adipofascial Flap Reconstruction of Distal Fingertips Fabiana Battaglia, Michele Rosario Colonna, Luigi Troisi, Gabriele Delia 10.1016/j.jhsa.2026.02.020 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00166-8/fulltext?rss=yes Mucopolysaccharidosis type I (MPS-I), a genetic lysosomal storage disorder, often leads to musculoskeletal deformities such as trigger digits (TDs). Despite systemic therapies, connective tissues such as bone, muscle, and tendons remain difficult for the enzyme to reach, and TDs develop. We performed a retrospective study to assess the prevalence of TDs, evaluate surgical outcomes and recurrence, and explore accumulation of foam cell macrophages contributing to TD development in patients with MPS-I. Trigger Digits in Mucopolysaccharidosis Type I: Clinical Characteristics, Surgical Outcomes, and Histopathological Findings Boudewijn A.W. van Binsbergen, Joris A. van Dongen, Linda Vriend, Aebele B. Mink van der Molen, Peter M. van Hasselt 10.1016/j.jhsa.2026.02.018 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00163-2/fulltext?rss=yes This study reports health-related quality of life outcomes in children with Apert syndrome following syndactyly release, evaluating upper-extremity and cognitive function along with psychosocial factors. Findings can inform caregivers and providers to improve well-being for children with Apert syndrome. Health-Related Quality of Life Outcomes in Pediatric Patients With Apert Syndrome Hannah C. Brown, Laura C. Nuzzi, Joseph Upton, Brian I. Labow, Amir H. Taghinia 10.1016/j.jhsa.2026.02.015 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00149-8/fulltext?rss=yes This study aimed to describe how the pattern of arterial damage in traumatically amputated digits changes with increasing distance from the site of injury (SOI), how different mechanisms of injury affect that pattern, and to assess the viability of fresh, unembalmed, unfrozen cadavers for the histologic analysis of injuries. Arterial Zone of Injury After Different Mechanisms of Traumatic Finger Amputation Kyle Deistler, Omar Alghothani, Annie Orr, Christopher Pierson, Kanu Goyal 10.1016/j.jhsa.2026.02.013 Journal of Hand Surgery 51, 6 (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 51 6 S0363-5023(26)X2004-4 Arthroplasty/Arthrodesis: Curated by Gustavo Gómez Rodríguez 632.e1 632.e8 https://www.jhandsurg.org/article/S0363-5023(26)00138-3/fulltext?rss=yes This purpose of this study was to evaluate the patient-reported outcomes of surgically and nonsurgically treated complete and partial distal biceps tears (DBTs) and report the conversion-to-surgery rate for patients initially treated nonsurgically. Thirty-Six Percent Conversion to Surgery Rate for Nonsurgical Treatment of Complete and Partial Distal Biceps Tears Matthew J. Schultz, Samantha Riebesell, Stephanie Kwan, Tyler Radack, Michael Rivlin, Jacob Tulipan 10.1016/j.jhsa.2025.12.027 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00121-8/fulltext?rss=yes Three-dimensional T2-weighted SPACE (3D-T2-SPACE) magnetic resonance imaging (MRI) has demonstrated diagnostic validity for detecting intravertebral injuries in traumatic brachial plexus injury (BPI). This study aimed to classify preganglionic injuries based on 3D-T2-SPACE findings. Magnetic Resonance Imaging Classification Using the Three-Dimensional T2-weighted SPACE Method for Brachial Plexus Injury Kazuteru Doi, Yasunori Hattori, Sotetsu Sakamoto, Ayumi Suzuki, Jun Sasaki, Makimi Fujita, Ian Jason Magtoto 10.1016/j.jhsa.2026.02.002 Journal of Hand Surgery 51, 6 (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 51 6 S0363-5023(26)X2004-4 Pediatric Hand and Upper Extremity: Curated by Michelle James 679.e1 679.e12 https://www.jhandsurg.org/article/S0363-5023(25)00716-6/fulltext?rss=yes In a survey- and scenario-based experiment, we addressed the factors associated with surgeon recommendations for specific distal radius fracture treatment options, including patient financial insecurity and insurance coverage. Resource Utilization in the Management of Distal Radial Fracture Amin Razi, Niels Brinkman, Koen Odenijuis, David Ring, Sina Ramtin, Science of Variation Group 10.1016/j.jhsa.2025.12.012 Journal of Hand Surgery (2026) 2026-04-02 Journal of Hand Surgery 2026-04-02 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00214-5/fulltext?rss=yes Survivors of focal neurological injuries experience accelerated bone loss, particularly in the paretic upper extremity, substantially increasing the risk of fragility fractures. Mechanical unloading, neuromuscular impairment, and altered bone remodeling contribute to rapid reductions in bone mineral density and unfavorable changes in bone geometry within the first year after stroke and brachial plexus palsy. Despite growing evidence, bone health assessment is rarely incorporated into routine poststroke care, and referrals often occur only after fracture. Fragility Fractures in Focal Neurological Conditions Aslan Baradaran, Tamara D. Rozental 10.1016/j.jhsa.2026.02.027 Journal of Hand Surgery (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00165-6/fulltext?rss=yes Prospective clinical registries that apply standardized diagnostic criteria and established outcome measures have been developed globally to better understand congenital upper limb differences. This study explores the perspectives of surgeons who have been instrumental in forming and maintaining Congenital Upper Limb Difference registries in the United States (Congenital Upper Limb Difference), Northern Europe (Congenital Upper Limb Anomalies North), Australia (Australia Hand Difference Registry), and the United Kingdom (UK Hand Registry). Establishing and Maintaining Congenital Upper Limb Difference Registries: Insights From Global Experiences Adam Mosa, Sarah Romans, Charles A. Goldfarb, Lindley B. Wall 10.1016/j.jhsa.2026.02.017 Journal of Hand Surgery (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00148-6/fulltext?rss=yes Because of the biological, anatomical, and biomechanical characteristics of the scaphoid, treating some proximal pole nonunions remains challenging. The location of the nonunion (proximal or distal to the dorsal apex) may influence its natural history. Based on this concept, patients with a proximal pole nonunion located proximal to the dorsal apex and maintaining an intact insertion of the dorsal scapholunate ligament in the distal fragment of the scaphoid may benefit from simple excision of the proximal pole. Simple Excision of Proximal Scaphoid Nonunion: A Viable Option When the Scapholunate Ligament Is Intact Ana Scott-Tennent De Rivas, Pau Forcada Calvet, Mireia Esplugas Mimó, Ignacio Esteban Feliu, Guillem Salvà Coll, Álex Lluch Bergadà 10.1016/j.jhsa.2026.01.032 Journal of Hand Surgery (2026) 2026-04-01 Journal of Hand Surgery 2026-04-01 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00135-8/fulltext?rss=yes Dry arthroscopy of the wrist is comparable in safety to wet arthroscopy and is preferred in some cases as it avoids fluid extravasation. However, there is a potential for increased temperatures within the joint and risk of tissue damage. The purpose of this study was to document the maximum temperatures measured in a wrist simulator under dry and wet conditions using different arthroscopes and light sources. Are There Thermal Risks Associated With Dry Arthroscopy? A Simulated Comparison of Temperatures in Wet Versus Dry Wrist Arthroscopy Ridzwan Namazie, Minh NQ. Huynh, Ishvar Nedunchezhian, Randipsingh Bindra 10.1016/j.jhsa.2026.01.026 Journal of Hand Surgery 51, 6 (2026) 2026-03-26 Journal of Hand Surgery 2026-03-26 51 6 S0363-5023(26)X2004-4 Arthroscopy/Ligament: Curated by Sanjeev Kakar 634 640 https://www.jhandsurg.org/article/S0363-5023(26)00150-4/fulltext?rss=yes The primary aim of this study was to assess the long-term survival rate of proximal interphalangeal (PIP) joint denervation, defined as the duration until revision with a salvage procedure. The secondary aims were to evaluate pain relief, patient satisfaction, progression of osteoarthritis, and factors associated with treatment failure. Long-Term Survival of Proximal Interphalangeal Joint Denervation of the Hand: Time-to-Event Analysis Fernando Holc, Pierre-Emmanuel Chammas, Oliver Esslinger, Alexandre Dorfmann, Jefferson Braga Silva, Michel Chammas, Jorge G. Boretto 10.1016/j.jhsa.2026.01.033 Journal of Hand Surgery 51, 6 (2026) 2026-03-25 Journal of Hand Surgery 2026-03-25 51 6 S0363-5023(26)X2004-4 Nerve: Curated by Harvey W. Chim 656 664 https://www.jhandsurg.org/article/S0363-5023(26)00057-2/fulltext?rss=yes Vasopressor-induced digital ischemia is an uncommon but severe complication of life-preserving therapy in critically ill patients, arising from profound peripheral vasoconstriction that can progress from reversible hypoperfusion to irreversible necrosis and amputation. This review synthesizes current evidence on epidemiology, mechanisms of injury, early recognition, and management strategies relevant to the hand surgeon. Early ischemic changes—digital coolness, discoloration, and delayed capillary refill—may respond to timely interventions, such as active warming, topical nitrates, botulinum toxin A, and regional anesthesia-mediated sympatholysis. Vasopressor-Induced Digital Ischemia: Management and Treatment Considerations Lacey Marie Smith, Nicole Schroeder, Gopal Ram Lalchandani 10.1016/j.jhsa.2026.01.007 Journal of Hand Surgery 51, 6 (2026) 2026-03-24 Journal of Hand Surgery 2026-03-24 51 6 S0363-5023(26)X2004-4 Review: Curated by Ruby Grewal 709 713 https://www.jhandsurg.org/article/S0363-5023(26)00122-X/fulltext?rss=yes The radial head and neck feature a unique anatomical structure, whereby the application of a plate in certain areas can lead to impingement, subsequently restricting the forearm rotation. Various techniques have been suggested to identify the appropriate region for plate fixation. We propose an alternative method to locate a safe zone for plate placement and conduct a comparative analysis with previously established methods. A Simplified Method for Determining the Safe Zone in Proximal Radial Plate Fixation Piyabuth Kittithamvongs, Prapasiri Chareonsri, Sopinun Siripoonyothai, Navapong Anantavorasakul, Kanchai Malungpaishrope, Chairoj Uerpairojkit 10.1016/j.jhsa.2026.02.003 Journal of Hand Surgery (2026) 2026-03-21 Journal of Hand Surgery 2026-03-21 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00120-6/fulltext?rss=yes Fractures of the thumb encompass a diverse spectrum of injury patterns, each requiring nuanced consideration of various treatment strategies. Associated conditions include injuries to the ulnar collateral ligament and radial collateral ligament of the metacarpophalangeal joint, which can significantly impact thumb stability and function. Although extra-articular fractures of the thumb metacarpal and phalanges are more tolerant of residual deformity due to compensatory movement of the carpometacarpal joint, intra-articular fractures, including Bennett and Rolando fractures, often benefit from surgical intervention to restore articular congruity. Thumb Fractures and Associated Injuries: An Evidence Based Review to Guide Treatment Brian W. Yang, Robin N. Kamal, Lauren M. Shapiro 10.1016/j.jhsa.2026.02.001 Journal of Hand Surgery (2026) 2026-03-20 Journal of Hand Surgery 2026-03-20 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00125-5/fulltext?rss=yes Ring avulsion injuries, though rare, represent a uniquely devastating subset of hand trauma, with circumferential damage to skin, tendon, bone, and neurovascular structures. Historically, these injuries were almost universally treated with amputation; however, advances in microsurgical repair have transformed management and opened the possibility of finger salvage. We review the epidemiology, classification systems, treatment options, and biomechanical studies that have prompted innovations in ring manufacturing. Current Concepts in Ring Avulsion Injuries Lacey Smith, Igor Immerman, Nicole Schroeder, Lauren M. Shapiro 10.1016/j.jhsa.2026.01.020 Journal of Hand Surgery (2026) 2026-03-19 Journal of Hand Surgery 2026-03-19 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00144-9/fulltext?rss=yes The management of chronic tendinous mallet finger resulting from extensor tendon insertion rupture presents a considerable challenge. To our knowledge, this study describes a clinical technique using a brachioradialis tendon-bone graft to reconstruct the extensor apparatus. Repairing Chronic Tendinous Mallet Finger by Brachioradialis Tendon-Bone Graft Lei Wang, Baolu Guo, Hongliang Zhu, Xiaogen Li, Xinqing Gu 10.1016/j.jhsa.2026.02.011 Journal of Hand Surgery 51, 6 (2026) 2026-03-18 Journal of Hand Surgery 2026-03-18 51 6 S0363-5023(26)X2004-4 Tendon: Curated by Armin Kraus 685.e1 685.e6 https://www.jhandsurg.org/article/S0363-5023(26)00142-5/fulltext?rss=yes This study aims to determine the impact of injury mechanism energy level on clinical outcomes following Galeazzi fracture. Relationship of Injury Mechanism Energy to Postoperative Wrist Function in Galeazzi Fractures Jack C. Adams, Matthew W. Sgaglione, Sanjit R. Konda, Nirmal C. Tejwani, Kenneth A. Egol 10.1016/j.jhsa.2026.02.010 Journal of Hand Surgery (2026) 2026-03-18 Journal of Hand Surgery 2026-03-18 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00141-3/fulltext?rss=yes To develop a classification system for extra-articular distal radius fractures (DRFs) integrating radiographic parameters of instability, ulnar fractures, distal radioulnar (DRU) joint disruption, and carpal involvement and to evaluate its reliability. A Classification of Extra-articular Distal Radius Fractures With Associated Injuries Galal Hegazy, Mahmoud Seddik, Rashed Emam El-Sadek, Tarek Mansour, Elsayed Shaheen, Ibrahem El-Sebaey, Mohammed Alnahas, Mohamed Elhalawany, Abdulhamid Elzoghby, Mohamed Abdelaziz, Ahmed Darweash 10.1016/j.jhsa.2026.02.009 Journal of Hand Surgery (2026) 2026-03-15 Journal of Hand Surgery 2026-03-15 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00134-6/fulltext?rss=yes Although carpal tunnel release (CTR) is the most common upper-extremity orthopedic procedure in the United States, revision surgery can be indicated when symptoms of carpal tunnel syndrome persist, recur, or worsen after primary surgery. Understanding the revision surgery profile after CTR is important for preoperative counseling and treatment decision-making, yet published rates of revision surgery vary widely. In our study, we aimed to establish the rate of revision CTR and describe temporal patterns of revisions after primary surgery for patients with long-term follow-up at our institution. The Rate and Timing of Revision Carpal Tunnel Release with Long-Term Follow-Up Rose M. Gold, Philip E. Blazar, Leah R.F. Demetri, Brandon E. Earp, Dafang Zhang 10.1016/j.jhsa.2026.02.006 Journal of Hand Surgery 51, 6 (2026) 2026-03-13 Journal of Hand Surgery 2026-03-13 51 6 S0363-5023(26)X2004-4 Nerve: Curated by Harvey W. Chim 665.e1 665.e7 https://www.jhandsurg.org/article/S0363-5023(26)00131-0/fulltext?rss=yes To assess scapholunate bridge augmentation with all-suture, knotless anchors in cadaveric wrists through evaluation of radiographic parameters, by comparing the bridged wrist to the wrist with an intact scapholunate interosseous ligament (SLIL) and sectioned SLIL. Biomechanics of a Scapholunate Bridge Augmentation Technique Using All-Suture, Knotless Anchors Rafa Rahman, Kathleen N. Meyers, Raylin Xu, Michael Mazzucco, Michelle Carlson 10.1016/j.jhsa.2026.01.025 Journal of Hand Surgery 51, 6 (2026) 2026-03-13 Journal of Hand Surgery 2026-03-13 51 6 S0363-5023(26)X2004-4 Arthroscopy/Ligament: Curated by Sanjeev Kakar 642.e1 642.e10 https://www.jhandsurg.org/article/S0363-5023(26)00127-9/fulltext?rss=yes Lymphedema may be primary (because of congenital lymphatic abnormalities) or secondary (commonly caused by cancer treatments). It progresses from pitting edema to fibrotic, nonpitting swelling. Diagnosis involves limb measurements and imaging like lymphoscintigraphy, indocyanine green lymphography, and magnetic resonance imaging lymphangiography. Treatment begins with complete decongestive therapy, and unresponsive cases may undergo microsurgical procedures such as lymphaticovenous shunts or vascularized lymph node transfer. Hand Surgery in Patients with a History of Lymphedema: A Review of Current Concepts and Opinions Lefko T. Charalambous, Benjamin Padon, Lawerence J. Lin, Edward Mojica, Michael E. Rettig 10.1016/j.jhsa.2026.01.022 Journal of Hand Surgery (2026) 2026-03-13 Journal of Hand Surgery 2026-03-13 The Hand Surgery Landscape https://www.jhandsurg.org/article/S0363-5023(26)00137-1/fulltext?rss=yes In this review, we aim to discuss the history and future of the peer-review process within hand and upper-extremity surgery. In addition, this review will serve as a practical “how to” guide for reviewers by providing strategies and insights aimed at improving the quality of manuscript reviews. Prereview considerations, such as content, statistical expertise, bias, and potential conflicts of interest, will be addressed. Topics relative to each manuscript section will be presented including common methodological errors. Peer Review in Upper-Extremity Surgery: Essential Strategies for Reviewers Rafa Rahman, Louis C. Grandizio, Eitan Melamed 10.1016/j.jhsa.2026.02.007 Journal of Hand Surgery 51, 6 (2026) 2026-03-11 Journal of Hand Surgery 2026-03-11 51 6 S0363-5023(26)X2004-4 Review: Curated by Ruby Grewal 714 718 https://www.jhandsurg.org/article/S0363-5023(26)00146-2/fulltext?rss=yes This study aimed to explore the risk factors for postoperative displacement of the dorsal ulnar fragment following volar locking plate fixation in distal radius fractures and to develop a clinical prediction model. Postoperative Displacement of the Dorsal Ulnar Fragment After Volar Locking Plate Fixation: Risk Factors and Clinical Prediction Tool Jia-qing Ji, Dang Ma, Yong-gang Lu, Abudureyimu, Yan-ben Wang, Chao Jiang, Kai Chen, Feng Yuan, Jian Fan 10.1016/j.jhsa.2026.02.012 Journal of Hand Surgery (2026) 2026-03-10 Journal of Hand Surgery 2026-03-10 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00133-4/fulltext?rss=yes Postoperative clinical follow-up is standard practice for wound monitoring, patient reassurance, and surgical outcome assessment. However, overburdened health care systems necessitate optimized resource allocation. This study evaluates the utility of routine postoperative follow-up after elective, noninfectious soft tissue upper limb procedures. The Yield of Postoperative Clinical Follow-Up Following Minor Hand Surgery: Is a Face-to-Face Encounter Necessary? Tal Frenkel Rutenberg, Amir Shmuel Kohav, Tom Kosnekov, Asaf Shimshon, Yona Kosashvili, Sorin Daniel Iordache 10.1016/j.jhsa.2026.02.005 Journal of Hand Surgery 51, 6 (2026) 2026-03-10 Journal of Hand Surgery 2026-03-10 51 6 S0363-5023(26)X2004-4 Basic Science: Curated by Gregory Couzens 699.e1 699.e7 https://www.jhandsurg.org/article/S0363-5023(26)00064-X/fulltext?rss=yes Assessment of the microstructure of the distal radius demonstrates that the ulnar and volar cortices are the load-bearing components of the radius. We hypothesize that the center of rotation (COR) for the wrist lies directly distal to these cortices. The aim of this study was to define the radiographic relationship between the distal radius and the COR. The Distal Radius Ulnar and Volar Cortices Are a Reliable Radiographic Marker of the Normal Wrist Centre of Rotation Reuben Yang Chua, Simon Francis Bellringer, Kim Thien Pham, Ameya Bhanushali, Ryan Eng Ming Tay, Gregory Ian Bain 10.1016/j.jhsa.2025.12.025 Journal of Hand Surgery 51, 6 (2026) 2026-03-04 Journal of Hand Surgery 2026-03-04 51 6 S0363-5023(26)X2004-4 Basic Science: Curated by Gregory Couzens 698.e1 698.e7 https://www.jhandsurg.org/article/S0363-5023(26)00050-X/fulltext?rss=yes Thumb carpometacarpal joint arthrosis is the second most common form of degenerative joint disease in the hand but the most frequent form of arthrosis treated surgically. Traditional surgical management involving trapeziectomy dates to the 1940s, with several modifications having evolved to improve stability, strength, appearance, and convalescence. However, although most outcomes of resection arthroplasty are good, they fail to completely restore the joint to its previous vitality, and strong clinical evidence of superiority of any technique is lacking. Total Joint Arthroplasty for the Thumb Carpometacarpal Joint Rick Tosti, Joris Duerinckx 10.1016/j.jhsa.2026.01.003 Journal of Hand Surgery (2026) 2026-03-04 Journal of Hand Surgery 2026-03-04 Current Concepts https://www.jhandsurg.org/article/S0363-5023(26)00054-7/fulltext?rss=yes Kirschner wire (K-wire) infections continue to be a challenge in hand surgery. Our purpose was to quantify the frequency of K-wire site infections of the hand and wrist, to tabulate major and minor infectious manifestations, to identify factors that may predispose a patient to major complications, and to generate an updated algorithm for prognostication and treatment of K-wire site infections. Kirschner Wire Skeletal Fixation in the Hand and Wrist: Risk of Infection and Predictors of Progression to Major Complications Mitchell S. Mologne, Julia M. Perugini, Nicholas A. Calotta, Lindley B. Wall, Charles A. Goldfarb 10.1016/j.jhsa.2026.01.005 Journal of Hand Surgery (2026) 2026-03-02 Journal of Hand Surgery 2026-03-02 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00123-1/fulltext?rss=yes This study compared cadaveric distal ulnar neck fractures following fixation with either retrograde intramedullary threaded nail (IMTN) fixation or volar-locked plate and screw (VLPS) fixation. We hypothesized that there would be no differences in fatigue resistance between the two methods. Stability of Distal Ulnar Neck Fractures During Cyclic Loading Following Intramedullary Threaded Nail Fixation or Volar-Locking Plate and Screw Fixation: A Cadaveric Biomechanical Comparison Alexander D. Jeffs, Andrew D. Allen, Rahul Radhakrishna, Stephen M. Himmelberg, Zohair S. Zaidi, Gregory M. Knoll, J. Megan Patterson, Jacqueline H. Cole, Reid W. Draeger 10.1016/j.jhsa.2026.01.018 Journal of Hand Surgery (2026) 2026-02-28 Journal of Hand Surgery 2026-02-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(26)00061-4/fulltext?rss=yes To evaluate the biomechanical performance of the modified Brunelli scapholunate interosseous ligament (SLIL) reconstruction with and without suture augmentation, using a cadaveric model under cyclic loading conditions. Scapholunate Ligament Reconstruction with Suture Augmentation: a Biomechanical Analysis Michael A. Bergen, Jinseong Kim, Lauren E. Piana, Joseph Cusano, Myles Dworkin, Rachel Schilkowsky, Janine Molino, Joseph Gil 10.1016/j.jhsa.2025.12.024 Journal of Hand Surgery 51, 6 (2026) 2026-02-28 Journal of Hand Surgery 2026-02-28 51 6 S0363-5023(26)X2004-4 Arthroscopy/Ligament: Curated by Sanjeev Kakar 641.e1 641.e7 https://www.jhandsurg.org/article/S0363-5023(25)00728-2/fulltext?rss=yes Chronic limb-threatening ischemia of the upper extremity, resulting from pathologies like vasospasm, occlusion, trauma, or end-stage renal disease, is challenging to manage because of severe pain and morbidity. This review seeks to summarize the vascular anatomy of the upper extremity at risk for chronic limb-threatening ischemia, explain the pathophysiology of ischemic pain signaling, review diagnostic testing, and explore medical and surgical pain management options, as well as introduce avenues for future research. Diagnosis, Pathology, and Management of Pain in the Ischemic Hand: A Comprehensive Review Ellis Berns, Thompson Zhuang, Anna H. Ohlsson, Hannah H. Lee 10.1016/j.jhsa.2025.12.022 Journal of Hand Surgery 51, 6 (2026) 2026-02-25 Journal of Hand Surgery 2026-02-25 51 6 S0363-5023(26)X2004-4 Review: Curated by Ruby Grewal 700 708 https://www.jhandsurg.org/article/S0363-5023(26)00055-9/fulltext?rss=yes Intramedullary screws in single- or double-screw configurations are increasingly used for proximal phalanx (P1) fractures. Our purpose was to assess the biomechanical rotational stability of antegrade one- versus two-screw constructs in the fixation of simulated transverse mid-diaphyseal P1 fractures. Rotational Stability of One Versus Two Intramedullary Screws for Proximal Phalanx Fractures: A Biomechanical Study Rae Tarapore, Andrew O’Brien, Zakkary Walterscheid, Manaswini Chennoju, Pooyan Abbasi, Kenneth R. Means, Aviram M. Giladi 10.1016/j.jhsa.2026.01.011 Journal of Hand Surgery (2026) 2026-02-16 Journal of Hand Surgery 2026-02-16 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(26)00059-6/fulltext?rss=yes Madelung deformity is a rare congenital wrist deformity characterized by growth disturbance of the volar–ulnar aspect of the distal radial physis, leading to progressive wrist deformity, pain, and stiffness. Madelung deformity is frequently associated with genetic conditions such as Leri–Weill dyschondrosteosis and Turner syndrome, and more recently, mutations in the GNAS gene have been implicated. Diagnosis is based on clinical findings and radiographic criteria, with plain radiographs demonstrating characteristic volar–ulnar radial curvature, positive ulnar variance, and carpal subluxation. Madelung Deformity: A Current Concepts Review Eric R. Taleghani, Mason Price, Iris Gutmark-Little, Kevin J. Little 10.1016/j.jhsa.2026.01.009 Journal of Hand Surgery (2026) 2026-02-13 Journal of Hand Surgery 2026-02-13 Review Article https://www.jhandsurg.org/article/S0363-5023(26)00052-3/fulltext?rss=yes Assessing triquetral alignment aids in evaluating carpal instability, but no reliable methods have been established. This study assessed factors affecting the reliability of triquetral angle measurements by experienced observers and used a computer-aided analysis software to establish normal values for triquetral alignment. Triquetral Alignment: Measurement Techniques, Reliability, and Normal Values Robert Sippo, Kira Huuska, Theresa Höglund, Eero Waris 10.1016/j.jhsa.2025.12.023 Journal of Hand Surgery (2026) 2026-02-12 Journal of Hand Surgery 2026-02-12 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00721-X/fulltext?rss=yes Hand trauma is a challenge to triage and manage, especially in rural states, because of the relative paucity of fellowship-trained hand surgeons and equipped treatment centers. Since the establishment of the Arkansas Hand Trauma Telemedicine Program (AHTTP) in 2014, early data suggest a successful reduction in hospital transfers for hand trauma. The purpose of this economic and decision analysis study was to perform a comprehensive, longer-term analysis describing trends in emergency medical service (EMS) transfer rate for hand trauma in Arkansas in relation to the establishment of AHTTP. Ten Years of a Novel Telemedicine System for Management of Statewide Hand Trauma Decreases EMS Transfer Rate and Health Care Costs in Arkansas Katherine Montoya, Amy Schexnayder, Austin Porter, Theresa Wyrick 10.1016/j.jhsa.2025.12.015 Journal of Hand Surgery (2026) 2026-02-07 Journal of Hand Surgery 2026-02-07 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00713-0/fulltext?rss=yes The Personal Meaningful Gain (PMG) is a construct identifying a patient’s self-defined improvement goal, capturing the individual’s threshold to be satisfied with treatment results. Previous research shows that patients who achieve their expressed PMG should be satisfied with their treatment results, but this is not always the case. This study explored the lived experiences of patients who were dissatisfied with their treatment results despite having achieved their expressed PMG. Understanding Why Certain Patients With Hand and Wrist Conditions Are Dissatisfied Despite Achieving Their Expressed Personal Improvement Goals Anchored at Satisfaction: A Qualitative Study Grada R. Arends, Yara E. van Kooij, Brocha Z. Stern, Steven E.R. Hovius, Robbert M. Wouters, Hand-Wrist Study Group, Willemijn A. de Ridder 10.1016/j.jhsa.2025.12.009 Journal of Hand Surgery 51, 6 (2026) 2026-01-29 Journal of Hand Surgery 2026-01-29 51 6 S0363-5023(26)X2004-4 Basic Science: Curated by Gregory Couzens 687 697 https://www.jhandsurg.org/article/S0363-5023(25)00723-3/fulltext?rss=yes To the best of our knowledge, no prior biomechanical study has determined how much fracture obliquity can be tolerated with intramedullary screw fixation. The purpose of this study was to compare the stiffness, load to failure, and fracture gapping of intramedullary fixation for oblique metacarpal fractures. Intramedullary Fixation for Short and Long Oblique Metacarpal Fractures: A Biomechanical Analysis Dang-Huy Do, Angel Valencia, Scott Oishi, Douglas Sammer, Daniel Koehler 10.1016/j.jhsa.2025.12.017 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00720-8/fulltext?rss=yes Internal fixation with a headless compression screw has become the gold standard for the surgical treatment of scaphoid fractures. Some authors reported on the theoretical benefit of dual screw fixation. Our aim was to investigate the optimal dual screw configuration for fixing scaphoid fractures with regard to biomechanical stability. Finite Element Analysis of Dual Screw Configurations for Enhanced Stability in Scaphoid Fracture Fixation Esin Rothenfluh, Sambhav Jain, William R. Taylor, Seyyed Hamed Hosseini Nasab 10.1016/j.jhsa.2025.12.014 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00709-9/fulltext?rss=yes The aim of our study was to perform a cost-utility analysis comparing trapeziometacarpal joint (TMJ) implant arthroplasty with resection-suspension-interposition arthroplasty (RSIA) during 1 year after surgery. Cost-Effectiveness of Trapeziometacarpal Dual Mobility Implant Arthroplasty Compared to Resection Arthroplasty Miriam Marks, Kei Mathis, Stephan Schindele, Daniel B. Herren 10.1016/j.jhsa.2025.12.005 Journal of Hand Surgery (2026) 2026-01-28 Journal of Hand Surgery 2026-01-28 Editor's Choice https://www.jhandsurg.org/article/S0363-5023(25)00722-1/fulltext?rss=yes Numerous studies have compared locking and grasping loop tendon repair configurations, with varying results. This study aimed to synthesize biomechanical evidence from experimental laboratory studies comparing these two configurations under linear static loading. Comparison of Locking and Grasping Loops in Similar Repair Techniques: A Systematic Review and Meta-analysis Benjamin Riski, Jaakko A.E. Kuronen, Olli V. Leppänen, Teemu Karjalainen, Lasse Linnanmäki 10.1016/j.jhsa.2025.12.016 Journal of Hand Surgery (2026) 2026-01-21 Journal of Hand Surgery 2026-01-21 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00660-4/fulltext?rss=yes The purpose of this study was to compare the clinical outcomes, radiographs, and complications of radial head arthroplasty in patients with concomitant Monteggia or transolecranon fracture dislocations to patients with isolated radial head fractures. The Effect of an Associated Monteggia or Transolecranon Fracture Dislocation on Outcomes of Radial Head Arthroplasty Jimmy Tat, Chloe Cadieux, Ruby Grewal, George S. Athwal, Kenneth J. Faber, Darren S. Drosdowech, Graham J.W. King 10.1016/j.jhsa.2025.11.014 Journal of Hand Surgery (2026) 2026-01-14 Journal of Hand Surgery 2026-01-14 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00666-5/fulltext?rss=yes This study aimed to assess the long-term clinical and radiologic results after hemi-hamate arthroplasty in patients with acute or chronic irreparable fractures of the base of the middle phalanx. Long-Term Clinical and Radiological Results of Hemi-Hamate Arthroplasty for Proximal Interphalangeal Fracture Dislocation Farid Najd Mazhar, Romina Rezaei Noei, Bushra Zareie, Hooman Shariatzade, Meisam Jafari Kafiabadi, Narges Akhlaghi, Omid Mahmoudi Nasab 10.1016/j.jhsa.2025.11.020 Journal of Hand Surgery 51, 6 (2026) 2026-01-13 Journal of Hand Surgery 2026-01-13 51 6 S0363-5023(26)X2004-4 Fracture: Curated by Stephen Tham 643 651 https://www.jhandsurg.org/article/S0363-5023(25)00658-6/fulltext?rss=yes First dorsal compartment tendonitis is a common cause of radial wrist pain. Initial treatments include corticosteroid injections, bracing, and anti-inflammatory medications, with surgical release reserved for persistent symptoms. This study investigated the efficacy of injections and intervention-free survival time. Intervention-Free Survival Analysis Following Corticosteroid Injection in First Dorsal Compartment Tendonitis Joshua K. Kim, Suhail K. Mithani, Warren C. Hammert 10.1016/j.jhsa.2025.11.013 Journal of Hand Surgery (2026) 2026-01-07 Journal of Hand Surgery 2026-01-07 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00607-0/fulltext?rss=yes Bennett fractures are inherently unstable intra-articular fractures of the first metacarpal base and are subject to multiple deforming forces. Suboptimal treatment can lead to fracture displacement, malunion, and post-traumatic arthritis of the carpometacarpal joint. The purpose of this study was to evaluate three fixation techniques for the stabilization of Bennett fractures. Our hypothesis was that screw fixation would be stiffer than the other methods. A Biomechanical Cadaveric Comparison of Three Fixation Methods for Bennett Fractures Seth A. Ahlquist, Erika Hookasian, Christopher R. Gajewski, Binglong Lee, David J. Graham, Brahman S. Sivakumar, Neil F. Jones, Edward Ebramzadeh, Sophia N. Sangiorgio 10.1016/j.jhsa.2025.10.021 Journal of Hand Surgery (2025) 2025-12-13 Journal of Hand Surgery 2025-12-13 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00576-3/fulltext?rss=yes Anterior radial head instability may persist with anatomic restoration of the ulna in anterior Monteggia fractures, leading to poor outcomes. The purpose of this study was to evaluate the effect of apex posterior ulnar overcorrection on radial head (RH) stability in the setting of anterior Monteggia fractures. It was hypothesized that increasing apex posterior angulation of the ulna, as well as a supinated forearm position, would decrease anterior RH translation. Apex Posterior Overcorrection of the Ulna Increases Radial Head Stability in Anterior Monteggia Fractures: An In Vitro Biomechanical Study Kirk Vannitamby, Carlos Prada, Cole T. Fleet, James A. Johnson, Graham J.W. King 10.1016/j.jhsa.2025.10.010 Journal of Hand Surgery (2025) 2025-11-27 Journal of Hand Surgery 2025-11-27 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00579-9/fulltext?rss=yes Intramedullary headless compression screw (IHCS) fixation of metacarpal (MC) fractures is popular. A concern for distal fractures is the potential loss of fragment/head fixation and with intra-articular incursion of hardware. We evaluated the biomechanical stability of IHCS fixation of progressively distal MC osteotomies using a cadaveric simulated active motion model. Intramedullary Screw Fixation of Distal Metacarpal Fractures: A Biomechanical Study Matthew Tarabochia, Sierra Lindsey, Ritu Agarwal, Pooyan Abbasi, Gabriel Yohe, Kenneth R. Means, Christopher L. Forthman 10.1016/j.jhsa.2025.10.013 Journal of Hand Surgery 51, 6 (2026) 2025-11-19 Journal of Hand Surgery 2025-11-19 51 6 S0363-5023(26)X2004-4 Scientific Article 655.e1 655.e7 https://www.jhandsurg.org/article/S0363-5023(25)00575-1/fulltext?rss=yes To report the effect of the bridge-combined internal fixation system to achieve simplified ulnar shortening osteotomy in the treatment of ulnar impaction syndrome. The Ortho-Bridge System for Simplified Ulna-Shortening Osteotomy Xiaoqing He, Jianping Zhang, Wenqian Mo, Ying Xiong, Yongqing Xu, Xi Yang 10.1016/j.jhsa.2025.10.009 Journal of Hand Surgery (2025) 2025-11-19 Journal of Hand Surgery 2025-11-19 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00531-3/fulltext?rss=yes To investigate whether a Y-strut configuration of dual headless compression screws provides greater force to failure when compared with a single intramedullary screw (IMS) in the fixation of proximal phalanx fractures. Biomechanical Evaluation of Y-Strut Dual Headless Compression Screws Versus Single Intramedullary Screw Fixation in Proximal Phalanx Fractures Samuel Lie, Philippe Massard-Combe, Sara Sadat Farshidfar, Mohammed Baba 10.1016/j.jhsa.2025.09.016 Journal of Hand Surgery (2025) 2025-10-30 Journal of Hand Surgery 2025-10-30 Scientific Article https://www.jhandsurg.org/article/S0363-5023(25)00467-8/fulltext?rss=yes Fourth and fifth carpometacarpal fracture dislocations may be missed on plain x-ray. The purpose of this study was to describe a radiographic measurement, the relative metacarpal shortening (RMS), to evaluate for fourth and fifth carpometacarpal fracture dislocations on posteroanterior radiographs. We hypothesize that the RMS will increase in patients with fourth and fifth carpometacarpal fracture dislocations relative to controls. Relative Metacarpal Shortening as a Radiographic Measure of Fourth and Fifth Carpometacarpal Fracture Dislocation Lilah Fones, Daniel Nemirov, Meysam Fathi Choghadeh, Pedro K. Beredjiklian 10.1016/j.jhsa.2025.08.011 Journal of Hand Surgery 51, 6 (2026) 2025-10-01 Journal of Hand Surgery 2025-10-01 51 6 S0363-5023(26)X2004-4 Fracture: Curated by Stephen Tham 654.e1 654.e7 https://www.jhandsurg.org/article/S0363-5023(25)00437-X/fulltext?rss=yes The use of plates in the treatment of Leddy-Packer type 3–5 flexor digitorum profundus tendon avulsion injuries is becoming increasingly prevalent; however, potential complications, including disruption of the avulsed bone fragment and damage to the flexor digitorum profundus tendon, may be encountered. The objective of this study was to ascertain whether the buttress plate technique, without screw placement in the avulsed fragment, can be employed as a treatment option for patients with type 3, 4, and 5 flexor digitorum profundus tendon avulsion injuries. Buttress Plating for Type 3-4-5 Jersey Finger Fractures: Without Bone Fragment Disruption and With a Challenging Rate of Hardware Removal–A Case Series Ömer F. Kümbüloğlu, Yusuf Altuntas, İsmail Demirkale 10.1016/j.jhsa.2025.07.038 Journal of Hand Surgery 51, 6 (2026) 2025-09-20 Journal of Hand Surgery 2025-09-20 51 6 S0363-5023(26)X2004-4 Fracture: Curated by Stephen Tham 652.e1 652.e7 https://www.jhandsurg.org/article/S0363-5023(25)00433-2/fulltext?rss=yes Comminuted olecranon fractures with free articular fragments pose considerable surgical challenges because of anatomical complexity and instability of the fracture fragments. This study evaluated the functional and radiological outcomes of embedded subchondral K-wire fixation combined with plate fixation. Clinical Results of Treatment of Comminuted Olecranon Fracture With Free Articular Fragments Using the Embedded Subchondral K-Wire Fixation Along With Plate Fixation Jin Sung Park, Seung-Hyun Cho, Kyoung-Tae Min, Jae Hoon Lee, Jin Ho Kim, Goo Hyun Baek 10.1016/j.jhsa.2025.07.035 Journal of Hand Surgery 51, 6 (2026) 2025-09-19 Journal of Hand Surgery 2025-09-19 51 6 S0363-5023(26)X2004-4 Fracture: Curated by Stephen Tham 653.e1 653.e7 https://www.jhandsurg.org/article/S0363-5023(26)00338-2/fulltext?rss=yes Journal CME Instructions 10.1016/S0363-5023(26)00338-2 Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 A16 https://www.jhandsurg.org/article/S0363-5023(26)00329-1/fulltext?rss=yes Table of Contents 10.1016/S0363-5023(26)00329-1 Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 A7 https://www.jhandsurg.org/article/S0363-5023(26)00328-X/fulltext?rss=yes Editorial Board 10.1016/S0363-5023(26)00328-X Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 A4 https://www.jhandsurg.org/article/S0363-5023(26)00327-8/fulltext?rss=yes Masthead 10.1016/S0363-5023(26)00327-8 Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 A2 https://www.jhandsurg.org/article/S0363-5023(26)00170-X/fulltext?rss=yes Dr Durand expresses concern that randomized controlled trials (RCTs) do not truly establish causality but only infer it statistically.1 We agree that causality in medicine—especially in surgery—is rarely reducible to a single mechanistic explanation. However, our editorial did not claim that RCTs demonstrate mechanistic causation; rather, we noted that they are designed to minimize bias and isolate the effect of an intervention within controlled parameters. As our article explained, these parameters are inherently more suited to pharmacologic trials than to surgical procedures, which vary based on skill, experience, and decision-making. Response to “Letter Regarding ‘Ten Reasons Why Prospective Randomized Studies in Surgery Are Flawed and Fundamentally Different From Drug Trials’” Alexander Y. Shin, Francisco del Piñal 10.1016/j.jhsa.2026.02.021 Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 Basic Science: Curated by Gregory Couzens e9 e10 https://www.jhandsurg.org/article/S0363-5023(25)00662-8/fulltext?rss=yes I would like to thank Shin and de Pinal1 for their article “Ten reasons why prospective randomized studies in surgery are flawed and fundamentally different from drug trials” published in The Journal of Hand Surgery. Their article finally states openly what many have whispered for years: the supposedly untouchable doctrine of evidence-based medicine collapses as soon as it is applied uncritically to surgery. While I fully agree with their clearly stated reasons, I believe certain points deserve further nuance to open a broader debate. Letter Regarding “Ten Reasons Why Prospective Randomized Studies in Surgery Are Flawed and Fundamentally Different From Drug Trials” Sébastien Durand 10.1016/j.jhsa.2025.11.016 Journal of Hand Surgery 51, 6 (2026) 2026-06 Journal of Hand Surgery 2026-06 51 6 S0363-5023(26)X2004-4 Letter to the Editor e7 e8